In June 2016, a 61-year-old man was hospitalised for Enterobacter cloacae peritonitis and severe abdominal sepsis with disseminated intravascular coagulation, secondary to a diaphragmatic hernia with bowel strangulation. The patient had a prolonged hospital course complicated by gangrene of the peripheral extremities, resulting in the amputation of the lower limbs and the development of large necrotic pressure sores.

Three months after admission, the patient was transferred to the Queen Astrid military hospital for surgical management of the pressure sores. Wound cultures on admission revealed colonisation with, amongst others, multidrug-resistant P. aeruginosa. One month after admission, the patient developed septicaemia with colistin-only-sensitive P. aeruginosa. Intravenous colistin therapy was started.

Bacteriophages are increasingly put forward as safe alternatives or additions to antibiotic therapy. Historical reports show that they were efficaciously used via the intravenous route, especially in typhoid fever and Staphylococcus aureus bacteremia, but this is—as far as we know—the first contemporary report of intravenous bacteriophage monotherapy against P. aeruginosa septicaemia in humans.

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